Method and cartridge for ligating organic tubular structures

ABSTRACT

A method and a staple cartridge for ligating a hollow organic tubular structure by means of surgical staples. The organic tubular structure is loosely confined within an area which is variable in accordance with the position of the ligating surgical staples. The staples, being U-shaped are moved toward the organic tubular structure, thereby decreasing the confining area, until the arms of the staples begin to bend around the structure. The staple arms are bent until they encircle the tubular structure and contact one another; then the staples are further deformed, by acting on the surfaces remote from the contacting arms, until the tubular structure is completely sealed. During the staplebending operation, the periphery of the tubular structure is positively controlled by the ligating cartridge, thereby ensuring the integrity of the structure.

United States Patent Noiles [54] METHOD AND CARTRIDGE FOR LIGATINGORGANIC TUBULAR STRUCTURES [72] Inventor: Douglas G. Noiles, New Canaan,

Conn.

[73] Assignee: United States Surgical Corporation,

Baltimore, Md.

[22] Filed: Aug. 18, 1970 [21] Appl. No.: 64,749

[56] References Cited UNITED STATES PATENTS 2/1961 Kelen ..29/243.57 X10/ 1961 Vogelfanger 128/326 X 4/ 1953 Garland ..128/346 X 3/1963 Babkin..29/243.57 6/1971 Green 128/305 1151 3,683,927 1 51 Aug. 15, 19723,545,444 12/1970 Green ..129/305 3,120,230 2/1964 Skold ..128/325Primary Examiner-Dalton L. Truluck Attorney-Fleit, Gipple & Jacobson[57] ABSTRACT A method and a staple cartridge for ligating a holloworganic tubular structure by means of surgical staples. The organictubular structure is loosely confined within an area which is variablein accordance with the position of the ligating surgical staples. Thestaples, being U-shaped are moved toward the organic tubular structure,thereby decreasing the confining area, until the arms of the staplesbegin to bend around the structure. The staple arms are bent until theyencircle the tubular structure and contact one another; then the staplesare further deformed, by acting on the surfaces remote from thecontacting arms, until the tubular structure is completely sealed.During the staple-bending operation, the periphery of the tubularstructure is positively controlled by the ligating cartridge, therebyensuring the integrity of the structure.

l4 Claim, 13 Drawing Figures Patented Aug. 15, 1972 3 Sheets-Sheet 1 v ll l I Ill||||l|||AIILIIIIIIIIIIIIIIIDl' DOUGLAS G. NOILES BY N @ fii,

ATTORNEYS Patented Aug. 15, 1972 3 Sheets-Sheet 2 INVENTOR DOUGLAS G.NOILES BY a 0 0%? f/f/ ATTORNEYS Patented Aug. 15, 1972 3,683,927

3 Sheets-Sheet 5 FIG. 13

l6 FIG. 12

INVENTOR DOUGLAS G. NOILES METHOD AND CARTRIDGE FOR LIGATING v ORGANICTUBULAR STRUCTURES BACKGROUND OF THE INVENTION In recent years, the useof staples in surgery has grown considerably in'popularity. For example,there are several automatic stapling instruments and cartridges whichhave been designed for ligating and dividing hollow tubular organicstructures. Three known cartridges, which will be described below,operate by first constricting the structure to be ligated between thejaws of the cartridge and then encircling the structure with a pair ofsurgical staples until the structure is sealed. Each of these knowncartridges sufiers from one serious drawback.

In copending US. Pat. application Ser. No. 672,362, filed on Oct. 2,1967, now US. Pat. No. 3,545,444, and assigned to the present assignee,a ligating surgical cartridge is disclosed which operates by firstconstricting the organic tubular structure to be ligated, between itsjaws, and by then bending a pair of relatively linear staples around thestructure until the structure is sealed off. During the bending of thestaples, there are portions of the tubular structure which are out ofthe control of the cartridge. That is, there are portions of the tubularstructure which are free from the positive constraining effects of thecartridge jaws, and which, therefore, are able to flex as a result offorces centered about other portions thereof. Due to this lack ofpositive control, the danger exists that the staples, when encirclingthe tubular structure, may pierce or scratch the structure. And whendealing with organic structures, such as blood vessels, punctures andsurface damage may lead to severe problems.

In copending US. Pat. Application Ser. No. 766,680, filed Oct. 1 l,1968, now Pat. No. 3,584,628, and copending US. Pat. application Ser.No. 32,247, filed Apr. 27, 1970, each assigned to the present assignee,two improved ligating cartridges are disclosed. In each of the improvedcartridges, the shape of the unbent staples is made non-linear, therebyresulting in a more effective closure of the organic tubular structure.However, notwithstanding the more effective staple shape, there arestill areas of the tubular structure which remain out of the control ofthe surgical cartridge. And, as described above, this lack of controlcarries with it the danger that the organic tubular structure may bepierced or scratched by the ligating staples.

It is toward the elimination of these prior art drawbacks that thepresent invention is directed.

SUMMARY OF THE INVENTION The present invention relates to a method and acartridge for applying a pair of ligating surgical staples to an organictubular structure in such a manner that the integrity of the structureis ensured. More particularly, the inventive method and cartridgeeliminate the drawbacks of the prior art by providing positive controlof the entire surface of the tubular structure during the staple-bendingportion of the ligating operation. In this manner, the ligating staplesencircle the organic tubular structure without the danger of piercing orscratching the surface thereof.

The present invention contemplates that the organic tubular structure tobe ligated, be loosely positioned within the jaws of a ligatingcartridge. The area within which the tubular structure :is maintained,being defined by a pair of linear side walls of the cartridge, a curvedanvil integral with the cartridge, and a pair of movable U-shapedstaples, is then gradually reduced by moving the U-shaped staples towardthe anvil. With continued movement of the staples, their arms are bentaround the anvil, encircle the tubular structure, and close upon oneanother. Then, the region of each staple remote from the point ofcontact between the staple arms is deformed and urged toward thecontacting staple arms, this deformation continuing until the organictubular structure is completely sealed. During the staple-bendingportion of the ligation, the entire periphery of the organic tubularstructure is positively controlled.

In the manner described above, the danger of piercing or mairing thesurface of the organic tubular structure is eliminated. By positivelycontrolling the entire surface area of the tubular structure, during thestaplebending stage of the procedure, it is possible to safely bend asurgical staple entirely around the structure, even with the staplecontacting the structure during the bending operation. This principle ofoperation of the present invention can easily be demonstrated by thereader with the aid of his finger, a. pin and a smooth surface. If thereader presses his finger against a smooth surface, he is able to slidea pin between his finger and the smooth surface, without injury, if hemaintains the point of the pin in contact with the smooth surface.Similarly, with the arms of the U-shaped staples in continuous contactwith the U-shaped anvils during the bending of the staple arms aroundthe organic tubular structure, the staples are bent without injury tothe tubular structure.

Accordingly, it is the main object of the present invention to provide amethod and an apparatus for ligat-. ing an organic tubular structurewith a surgical staple, in a manner which ensures the integrity of theorganic structure.

It is another object of the present invention to provide a method and anapparatus for safely ligating organic tubular structures by means ofsurgical staples and by doing so in an extremely simple manner.

Still a further object of the present invention is to provide a methodand an apparatus for safely andefficiently ligating an organic tubularstructure by means of surgical staples, by controlling the surface areaof the tubular structure at all times during the ligation.

These and other objects of the present invention, as well as many of theattendant advantages thereof, will become more readily apparent whenreference is made to the following description taken in conjunction withthe accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a side view of a surgicalcartridge, showing a portion of an associated firing instrument,designed in accordance with the teachings of the present invention;

FIG. 2 is a cross-section of the cartridge taken along line 2-2 of FIG.1;

FIG. 3 is a side view of the main body of the surgical cartridgeillustrated in FIG. 1;

FIG. 4 is a top view of the main body illustrated in FIG. 3;

FIG. 5 is a top view of the inventive cartridge illustrated in FIG. 1;

FIG. 6 is a cross-section of the inventive cartridge taken along line 66of FIG. I

FIG. 7 is a cross-section of the cartridge taken along line 7-7 of FIG.6;,

FIG. 8 is a cross-section similar to FIG. 7 but showing a portion of theinventive cartridge during the early stages of ligation;

FIGS. 9 through 12 are enlarged cross-sections through the inventivecartridge showing the staple formation during various stages of theligation; and

FIG. 13 is a front view of a staple showing the manner in which themating of the staple arms takes place.

DETAILED DESCRIPTION OF THE DRAWINGS With reference first to FIGS. 1 and2, the basic cartridge and its attachment to the firing instrument willbe described. The cartridge is shown generally at and comprises athree-piece main body portion 12, a pair of three-piece rail assemblies14 and a pair of pushers 16. The firing instrument is shown generally at18.

The firing instrument 18 may be of the type described in either U.S.Pat. application Ser. No. 766,680 or U.S. Pat. application Ser. No.32,247, each mentioned above; and for purposes of description, only aportion of the firing instrument 18 will be described.

The instrument 18, at its forward end, is provided with a groove 20 anda thumb-operated cover plate 22; and as seen in FIGS. 1 and 5, thecartridge 10, at the rear end of the rail assemblies 14, is providedwith a coupling bar 24. Bar 24 is adapted to mate with the groove 20 andis held in position by the cover-plate 22. The three elements of eachrail assembly 14 are maintained in proper alignment by a plastic form26, and the coupling bar 24 ensures unity between the rail assembliesand the form 26. Cover plate 22 contacts the lower surface of the form26.

The output of the firing instrument 18 takes the form of a pair ofshafts 28 and 30, each movable with respect to the front nose 32 of thefiring instrument 18. Shaft 28 lies within hollow shaft 30 and ismovable with respect thereto. On the forward end of the shaft 28 arepositioned a pair of shoulders 34, and on the forward end of the shaft30 are positioned a pair of shoulders 36. While the complete operationof the firing instrument 18 is not herein explained, suffice it to saythat upon activation of the instrument 18, the shafts 28 and 30, withtheir respective shoulders 34 and 36, move in unison, away from thefront nose 32 of the instrument 18. A biasing spring operates betweenthe shafts 28 and 30 and consequently between the shoulders 34 and 36.Therefore, when a differential force is exerted between the shafts 28and 30, of a magnitude greater than that of the biasing spring, relativemotion takes place and the shoulders 34 move away from the shoulders 36.The operation of the firing instrument 18, as it affects the operationof the cartridge 10, will be explained below.

As clearly seen in FIGS. 1 and 3, the rear region of the body 12 isprovided with a depression 38 adapted to mate with the forwardmost ofthe two shoulders 36. The other shoulder 36 contacts the rear of themain body 12. And, as seen in FIG. 1, the rear region of each pusher 16is provided with a notch 40, adapted to mate with the forwardmost of thetwo shoulders 34. The other shoulder 34 contacts the rear of the pusher16. Therefore, the shoulders 34 and 36 serve, respectively, as saddleswithin which the pushers l6 and the main body 12 are seated andcontrolled.

Now, with reference to FIGS. 2 through 7, the elements of the cartridge10 will be described.

The three-piece main body 12, as shown best in FIGS. 2 and 7, takes theform of a central body member 42 sandwiched between a pair of coverplates 44. The central body member 42 and the cover plates 44 are heldtogether by means of four rivets or bolts 46. As seen best in FIGS. 2and 3, the central body member 42, when covered by plates 44, isprovided with a first elongated groove 48 and a second elongated groove50, groove 48 being the deeper of the two. The groove 48 may be termed arail guiding groove and the groove 50 may be termed a staple and pusherguiding groove.

The forward endof the central body member 42 is thin, is elongated, andis tapered at its extremity, as indicated by the numeral 52. Slightlyrearward of the taper 52, for reasons which will become apparent fromthe following, a section is removed from each side of the forward end ofthe main body member 42. Each side of the main body member 42, where asection is removed, has defined therein an angled sloping indented wall54.

The rear portion of the central body member 42, which is adapted to matewith the firing instrument 18, is open as shown at 55. In this manner,the shafts 28 and 30, and their associated shoulders 34 and 36, areeasily associated with the main body.

With reference now to FIGS. 5 through 7, the construction of the railassemblies 14 will be described. As can be seen in FIGS. 5 and 7, thecartridge 10 includes a pair of rail assemblies 14, each of theseassemblies being of three-piece construction. Each rail assembly 14comprises a central guide rail 56, an outer restraining plate 58 and aninner restraining plate 60. Inner restraining plate 60 is wider thanouter restraining plate 58, so as to ensure that the guide rails 14remain in the rail guiding grooves 48, defined between the central bodymember 42 and the cover plates 44. The integrity of each three-piecerail assembly 14 is ensured by a pin 61 passing through the outerrestraining plate 60, at the forward end thereof, and the plastic form26, with its bar 24, at the rear thereof.

As best seen in FIG. 6, the respective forward ends of the outerrestraining plate 58 and the inner restraining plate 60 are cut at anangle, as shown at 66, so as to mate with the sloping wall 52 on thecentral body member 42. Similarly, the forward end of the guide rail 56is cut at an angle, as shown at 64, so as to mate with the taper 54 onthe central body member 42. Therefore, and as illustrated in FIG. 8, themating of the faces 52 and 66 and the mating of the faces 54 and 64 issmooth and positive, so that the rail assembly 14 mates with the mainbody 12 defining a continuous anvil region 86.

Now, with reference to FIGS. 2 and through 10, the construction of thepushers 16 will be described. Each pusher 16 is elongated, is of aheight substantially equal to that of the staples and that of the pusherguiding groove 50, and is of a width slightly in excess of the thicknessof a staple, shown at 68. The forward end of each pusher 16 isdiminished in height from the remaining portions of the pusher and isrounded as shown at 70 in FIG. 10. For reasons which will become clearfrom the following, the rounded portion of each pusher takes a shape soas to comfortably unite with the rounded anvil regions 86. The radius ofthe curved pusher faces is, however, less than the radius of the curvedanvils so as to allow for the intermediate positioning of the organictubular structure and two thicknesses of the staple. On each flat sideof the rounded projection 70 a circular restraining disc 72 is secured.As best seen in'FIGS. 7, 9 and 10, the discs 72 ensure that the staples68 are held in proper alignment with the rounded projections 70 of thepushers l6, and as can be seen in FIG. 2, the shape of the grooves 50allows for the presence of these discs. The width of the pushers 16 isequal to the width of the respective central guide rails 56. Therefore,the bottom portions of the pushers 16 are guided by the guide rails 56.The pushers are restrained against unwanted transverse motion by theshape of the groove 50 and the restraining plates 58 and 60.

Now, the operation of the inventive cartridge will be explained. As canbe seen in FIG. 1, and like the cartridges disclosed in theabove-mentioned copending patent applications, the inventive cartridgeis made removable from the firing instrument, is made disposable, andmay be presterilized and packaged for shipment to the surgical arena.

For a discussion of the cartridge operation, the attention of the readeris directed to FIGS. 1 and 8 through 12. With the cartridge 10 mountedon the firing instrument 18, an organic tubular structure 76, such as ablood vessel, is inserted between the open respective ends of the railassemblies 14 and the main body 12 (FIG. 1). Arrow 74 indicates themanner in which the structure 76 is inserted. When the structure is inposition, as shown in phantom in FIG. 1, the surgeon activates thefiring instrument 18.

The initial action of the surgeon-operated firing instrument 18 is tosimultaneously move the shafts 28 and 30, and thus the shoulders 34 and36, away from the front nose 32 of the firing instrument 18. As a resultof the integrity between the shoulders 34 and the pushers l6, and theintegrity between the shoulders 36 and the main body 12, the main body12 of the cartridge 10, in unison with the pushers 16, move relative tothe rail assemblies 14. That is, the main body 12 and the pushers 16move in the direction of arrows 78 (FIG. 6), the rail assembly 14remaining stationary, being rigidly secured to the firing instrument 18.This relative motion continues until the mating of the main body 12 withthe rail assemblies 14, as illustrated in FIG. 8.

Once the mating faces of the main body 12 and the rail assemblies 14come into contact with one another, the main body can no longer move inthe direction of the arrow 78. Accordingly, continued force exerted onthe firing instrument 18 by the surgeon results in no relative motion ofelements until the differential force between the shafts 28 and 30 isreached. However, once this differential force is reached, the shaft 28moves forward within and with respect to the shaft 30. Accordingly,shoulders 34 move away from shoulders 36. Since the shoulders 34 are indirect association with the pushers 16, the pushers 16 move in thedirection of arrow shown in FIG. 8, the main body 12 and the railassemblies remaining stationary.

Once the pushers 16 begin to move relative to the main body 12, a pairof staples 68 are carried by the pushers along their respective guidetracks 82 and 84, shown in FIGS. 7 and 8. At this time, the organictubular structure 76 is loosely housed within the closed area defined bythe guide tracks 84, the anvil regions 86 and the inner walls of thecentral body member 42. When the staples are moved in the direction ofarrow 80 and reach the inner walls of the member 42, the confining areais then defined by the guide tracks 84, the anvil regions 86 and theinner walls of the U-shaped staples 68. The limiting confining area,before staple bending, is illustrated in FIG. 9.

From the initial movement of the staples 68 until the arms of thestaples contact the anvil regions 86, pusher movement merely moves thestaples in the direction of arrow 80 and diminishes the area in whichthe tubular structure is housed. Preferably, by the time when the armsof the staples contact the anvil regions, the organic structure 76 ispositively controlled in all regions of its periphery, by the anvilregions 86 and the inner walls of the staples 68. See FIG. 9.. While itis preferable that the tubular structure be of a size substantially asshown in FIG. 9, this sizing is not absolutely essential.

When the pusher 16 moves from the position shown in FIG. 9, that whereinthe staple arms meet the anvil regions, into the position shown in FIG.10, the arms of the U-shaped staples 68 ride along the curved walls ofthe anvils 86 and are bent by the anvils. At first, the staples bend asshown in FIG. 10, but further pusher movement forces the mating arms ofthe staples 68 to take the shape of the anvils 86. Then, the respectiveregions of the staples remote from the mating walls begin to collapse,the staples taking the form shown in FIG. 11. Here it can be seen howthe arms of the U-shaped staples are forced tightly against the curvedanvil 86 and how the bridges of the staples begin to collapse. Withcontinued movement of the pushers 16, the associated staples collapseuntil the tubular structure 76 is completely closed within the pair ofcollapsed staples 68, as shown in FIG. 12.

To ensure that the arms of the staples 68 properly mate with one anotherand to ensure that the staple collapse is proper, the extremities of thestaple arms are preferably shaped as shown in FIG. 13. In this Figure,it is seen that one arm of the staple 68 is V-shaped while the other armis pointed. The dimensions of the points are matched to the dimensionsof the V thereby ensuring positive contact therebetween. And, as seen inFIGS. 9 through 12, the forward ends of the staple arms may bewedge-shaped so as to ensure that the organic tubular structure ispushed out of the way of the closing staples. The staples are maderesilient and are made to have a relaxed arm-to-arm dimension in excessof the distance between the tracks in which they ride. In this manner,the staples are biased against the guide tracks at all times duringtheir advancement and during the bending operation.

As described above, the inventive cartridge comprises a pair of railassemblies, a pair of pushers, and is designed to eject a pair ofstaples for each activation of the firing instrument. In this manner,when a unitary tubular structure is positioned within the jaws of theinventive cartridge and the associated instrument is fired, a pair ofspaced apart staples close the tubular structure in two spacedlocations. Therefore, it is then possible to sever the tubular structureat any point intermediate the two staple positions without significantloss of blood. For this purpose, the instrument is preferably providedwith a knife 88 which may be associated with an externally positionedthumb-operated control bar 90. Therefore, once the pair of staples issecured in the structure 76, thus closing same in two positions, thecontrol bar 90 may be moved forward until the knife 88 severs theassociated tubular structure intermediate the pair of staples. Then, forexample, the surgeon is able to clear the interfering tubular structurefrom the surgical field.

Above, a specific embodiment of the present invention has beendescribed. It should be appreciated, however, that this embodiment isdescribed for purposes of illustration only and that numerousalterations "and modifications may be practiced by those skilled in theart without departing from the spirit and scope of the invention.Accordingly, it is the intent that the invention not be limited by theabove but be limited only as defined in the appended claims.

What is claimed is:

1. A cartridge adapted for removable insertion on a medical instrumentand having the capability of confining an organic tubular structure in aclosed area, causing the encirclement of the structure with a surgicalstaple, and causing the ligation of the structure with said surgicalstaple, the cartridge comprising: a first guide track assembly; a secondguide track assembly movable relative to said first guide trackassembly; said first and said second guide track assemblies being shapedand associated in such a manner as to define first and second positions;staple guide means extending along the length of said first and saidsecond guide track assemblies for guiding the movement of and thebending of'a surgical staple; curved anvil means on said first guidetrack assembly; said first and second guide track assemblies and saidcurved anvil means defining, when said first and said second guide trackassemblies are in their first position, an open housing; and said firstand said second guide track assemblies and said curved anvil meansdefining, when said first and said second guide track assemblies are intheir second position, a continuous U-shaped guide path; and pushermeans adapted for movement along and in the plane of said guide pathwhen said first and said second guide track assemblies are in theirsecond position; wherein said pusher means has a curved face adjacentthe curved face of said anvil means; wherein the curvature of said anvilmeans is less severe than the curvature of said pusher means; andwherein said first and said second guide track assemblies, said anvilmeans and said pusher means are shaped and associated so that when aU-shaped surgical staple is positioned in said guide track means withthe arms thereof extending toward said anvil means, and when said stapleis urged toward said anvil means by said pusher means, the arms of saidstaple are guided by said guide path until they contact one another andare bent into the shape of said rounded anvil means, the bridge of saidstaple remote from the contacting arms thereof is collapsed, and thestaple is deformed between said anvil means and said pusher means into aC-shape sealing said organic tubular structure.

2. The cartridge defined in claim 1, and further comprising: respectivesecond sets of guide track assemblies, anvil means and pusher means,spacially aligned with respect to the first sets thereof; said first andsaid second sets for sealing said organic tubular structure at first andsecond locations; and knife means for dividing said sealed organictubular structure intermediate said first and second positions.

3. The cartridge recited in claim 1, wherein said first guide trackassembly is adapted to be securely mounted on a medical instrument;wherein said second guide track assembly is slidably mounted withrespect to said first guide track assembly; and wherein said pushermeans is slidably mounted for movement relative both to said first andsaid second guide track assemblies.

4. The invention set forth in claim 3, wherein said pusher means slidesbetween said first and said second guide track assemblies.

5. The cartridge recited in claim 1, and further comprising: means onsaid first and said second guide track assemblies for ensuring smoothmating therebetween when said guide tract assemblies are moved fromtheir first position to their second position.

6. The cartridge defined in claim 1, wherein said second guide trackassembly is integral with a main body portion; wherein said first guidetrack assembly is slidably mounted in said main portion; and whereinsaid pusher means is slidably mounted within said main body portion.

7. The cartridge'recited in claim 6, and further comprising: respectivesecond sets of guide track assemblies, anvil means and pusher means,spacially aligned with respect to the first sets thereof; said first andsaid second sets for sealing said organic tubular structure at first andsecond locations; and knife means for dividing said sealed organictubular structure intermediate said first and second positions.

8. The cartridge recited in claim 1, wherein the face of said anvilmeans conforms to the circumference of a first circle; wherein the faceof said pusher means conforms to the circumference of a second circle;and wherein the radius of said first circle is larger than the radius ofsaid second circle by an amount at least equal to two staplethicknesses.

9. The cartridge defined in claim 1, and further comprising: first andsecond guide discs associated with said curved pusher means for ensuringpositive contact and alignment between said pusher means and saidstaple.

10. A method of surgically ligating an elongated organic structure of apatient by the use of a surgical staple, the method comprising the stepsof; incising the patient to expose the elongated organic structure to beligated; positioning a ligating instrument in the region of said organicstructure; freeing and inserting said organic structure in a closedhousing of the ligating instrument defined by the walls of a U-shapedguide track and an opposing U-shaped surgical staple; closing the areawherein said organic structure is housed by moving said U-shapedsurgical staple in said guide path; initially bending said U-shapedsurgical staple, along said U-shaped guide path, until the extremitiesof the arms thereof contact one another; collapsing the bridge of saidU-shaped staple until the collapsed staple takes a C-shape and ligatessaid organic structure; removing the ligating instrument from the regionof said organic structure; and closing the incision made in the patient.

11. The surgical method recited in claim 10, wherein the U-shaped guidetrack terminates in a curved anvil surface; and wherein the U-shapedstaple is moved and bent by a pusher having a curved face.

12. The surgical method recited in claim 11, wherein the curvature ofsaid anvil face is less severe than is the curvature of said pusherface.

13. The surgical method defined in claim 12, wherein the curvature ofsaid anvil face conforms to the circum- I

1. A cartridge adapted for removable insertion on a medical instrumentand having the capability of confining an organic tubular structure in aclosed area, causing the encirclement of the structure with a surgicalstaple, and causing the ligation of the structure with said surgicalstaple, the cartridge comprising: a first guide track assembly; a secondguide track assembly movable relative to said first guide trackassembly; said first and said second guide track assemblies being shapedand associated in such a manner as to define first and second positions;staple guide means extending along the length of said first and saidsecond guide track assemblies for guiding the movement of and thebending of a surgical staple; curved anvil means on said first guidetrack assembly; said first and second guide track assemblies and saidcurved anvil means defining, when said first and said second guide trackassemBlies are in their first position, an open housing; and said firstand said second guide track assemblies and said curved anvil meansdefining, when said first and said second guide track assemblies are intheir second position, a continuous U-shaped guide path; and pushermeans adapted for movement along and in the plane of said guide pathwhen said first and said second guide track assemblies are in theirsecond position; wherein said pusher means has a curved face adjacentthe curved face of said anvil means; wherein the curvature of said anvilmeans is less severe than the curvature of said pusher means; andwherein said first and said second guide track assemblies, said anvilmeans and said pusher means are shaped and associated so that when aU-shaped surgical staple is positioned in said guide track means withthe arms thereof extending toward said anvil means, and when said stapleis urged toward said anvil means by said pusher means, the arms of saidstaple are guided by said guide path until they contact one another andare bent into the shape of said rounded anvil means, the bridge of saidstaple remote from the contacting arms thereof is collapsed, and thestaple is deformed between said anvil means and said pusher means into aC-shape sealing said organic tubular structure.
 2. The cartridge definedin claim 1, and further comprising: respective second sets of guidetrack assemblies, anvil means and pusher means, spacially aligned withrespect to the first sets thereof; said first and said second sets forsealing said organic tubular structure at first and second locations;and knife means for dividing said sealed organic tubular structureintermediate said first and second positions.
 3. The cartridge recitedin claim 1, wherein said first guide track assembly is adapted to besecurely mounted on a medical instrument; wherein said second guidetrack assembly is slidably mounted with respect to said first guidetrack assembly; and wherein said pusher means is slidably mounted formovement relative both to said first and said second guide trackassemblies.
 4. The invention set forth in claim 3, wherein said pushermeans slides between said first and said second guide track assemblies.5. The cartridge recited in claim 1, and further comprising: means onsaid first and said second guide track assemblies for ensuring smoothmating therebetween when said guide tract assemblies are moved fromtheir first position to their second position.
 6. The cartridge definedin claim 1, wherein said second guide track assembly is integral with amain body portion; wherein said first guide track assembly is slidablymounted in said main portion; and wherein said pusher means is slidablymounted within said main body portion.
 7. The cartridge recited in claim6, and further comprising: respective second sets of guide trackassemblies, anvil means and pusher means, spacially aligned with respectto the first sets thereof; said first and said second sets for sealingsaid organic tubular structure at first and second locations; and knifemeans for dividing said sealed organic tubular structure intermediatesaid first and second positions.
 8. The cartridge recited in claim 1,wherein the face of said anvil means conforms to the circumference of afirst circle; wherein the face of said pusher means conforms to thecircumference of a second circle; and wherein the radius of said firstcircle is larger than the radius of said second circle by an amount atleast equal to two staple thicknesses.
 9. The cartridge defined in claim1, and further comprising: first and second guide discs associated withsaid curved pusher means for ensuring positive contact and alignmentbetween said pusher means and said staple.
 10. A method of surgicallyligating an elongated organic structure of a patient by the use of asurgical staple, the method comprising the steps of; incising thepatient to expose the elongated organic structure to be ligated;positioning a ligatiNg instrument in the region of said organicstructure; freeing and inserting said organic structure in a closedhousing of the ligating instrument defined by the walls of a U-shapedguide track and an opposing U-shaped surgical staple; closing the areawherein said organic structure is housed by moving said U-shapedsurgical staple in said guide path; initially bending said U-shapedsurgical staple, along said U-shaped guide path, until the extremitiesof the arms thereof contact one another; collapsing the bridge of saidU-shaped staple until the collapsed staple takes a C-shape and ligatessaid organic structure; removing the ligating instrument from the regionof said organic structure; and closing the incision made in the patient.11. The surgical method recited in claim 10, wherein the U-shaped guidetrack terminates in a curved anvil surface; and wherein the U-shapedstaple is moved and bent by a pusher having a curved face.
 12. Thesurgical method recited in claim 11, wherein the curvature of said anvilface is less severe than is the curvature of said pusher face.
 13. Thesurgical method defined in claim 12, wherein the curvature of said anvilface conforms to the circumference of a first circle; wherein thecurvature of said pusher face conforms to the circumference of a secondcircle; and wherein the radius of said first circle is greater than theradius of said second circle by at least two staple widths.
 14. Thesurgical method according to claim 10, and further comprising the stepsof: simultaneously ligating the elongated organic structure with asecond staple spaced from the first staple: and dividing the elongatedorganic structure at a location intermediate said first staple and saidsecond staple.